2018 Volume 51 Issue 10 Pages 640-648
Diagnosis of small bowel tumors is often delayed due to the fact that they are asymptomatic at the early stage. The clinical presentation is non-specific with small bowel obstruction, bleeding or perforated peritonitis. It is rare that small bowel tumors are diagnosed based on fistula formation or abscess with no perforated bowel. A 78-year-old man was admitted to our hospital because of abdominal pain lasting for two weeks. Abdominal CT scan showed an abdominal mass approximately 10 cm in diameter which contained liquid and air. Enema examination showed fistulae between some parts of the small intestine and the cavity lesion. A surgical operation was performed for treatment of fistulae and diagnostic purposes. We found that the abdominal abscess widely adhered to the small intestine and mesocolon. The abscess communicated with two sites of the small intestine. Partial resection of the small intestine was performed, but the abdominal mass was not completely removed. Histological findings indicated an enteropathy-associated T-cell lymphoma of the small intestine. After chemotherapy, the patient died 250 days after surgery. We report this case with a review of the literature and analysis of clinicopathological features of malignant lymphoma and gastrointestinal stromal tumor (GIST) of the small intestine with fistula.
